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Organization

PHYSICIANS LINK CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. AMY CHARLEY ESQ (CHIEF LEGAL OFFICER)
(240) 686-2300
Entity
Organization

Contact information

Practice address
630 E RIVER ST, ELYRIA, OH 44035-5902
(844) 474-4019
Mailing address
12420 MILESTONE CENTER DR STE 200, GERMANTOWN, MD 20876-7111
(406) 862-3002

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000214870
ANTHEM OHIO
OH
01
029281000
FEDERAL BLACK LUNG PROGRA
OH
01
127920900
US DEPT OF LABOR
OH
01
127920901
US DEPT OF LABOR
OH
01
CK2882
MEDICARE TRAVELERS RR - G
OH
Enumeration date
06/13/2006
Last updated
02/24/2023
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